Manager, Electronic Revenue Oversight (Hybrid)

Cleveland, Ohio

Employer: University Hospitals
Industry: Management - Non Clinical
Salary: Competitive
Job type: Full-Time
Manager, Electronic Revenue Oversight the responsibilities are;
  • Documentation and Coding

    • Collaborate with Director of Compliance and Providers over multiple specialties to align with entity standards

    • Coordinate and ensure all new providers, clinical staff, and charge staff are trained timely and uniformly upon hire in Documentation and Coding practices and expectations.

    • Monitor coding metrics against internal comparison groups and external benchmarks, measure adherence to standards and practices, identify and communicate outlier status to ensure regulatory and organizational compliance

    • Coordinate ongoing refresher faculty education, identify and arrange compliance audits as needed and provide ad hoc coding insights, education, guidance to faculty

    • Create, document and maintain workflow for services for appropriate clinical documentation for optimal coding in each ECC

  • Revenue Cycle Partnership

    • Collaborate with CBO managers to identify trends in coding edits and denials to coordinate provider training and EMR or ECC programming to resolve electronically.

    • Help to identify payer requirements to coordinate provider training and EMR or ECC programming to resolve electronically.

    • Coordinate monthly meetings between providers, clinical staff, charge staff and CBO managers to discuss process improvements.

  • Revenue Capture Optimization

    • Collaborate with Director of Electronic Revenue Oversight for UHPS for alignment and consistency of ECC solutions and workflow integrity across the entity

    • Oversee the operational workflow, review, reconciliation, EBEW, CEWL, and manual charge entry for all electronic and paper charge solutions used by provider groups (SCC Superbill, Inpatient Superbill, Surgery Superbill, Touchworks Virtual Ticket, Patient Keeper, I-Pro, Syngo, Muse, Softlab, CoPath, Provation,Soarian manual charge entry, CodeRyte to Soarian interface, Paper Charge Tickets, etc.). This will include charge entry and reconciliation within each EMR, each charge interface, and each batch created in Soarian, including manual charge entry processes.

    • Create, document, and maintain workflow diagrams for each charge solution as needed

    Review, validate, and maintain all job aids, LMS, and training classes related to charge capture

    • Educate staff and providers to successfully perform their ECC responsibilities

    • Create, document, and maintain reconciliation processes for all charge solutions in Pediatrics

    • Review and validate all reporting and work lists for charge reconciliation, create, validate and monitor workflow for practice operations including working of CEWL, EBEW, Incomplete Data Worklist and Outstanding Charges worklist

    • Oversee and maintain physician on-boarding requirements related to ECC solutions and revenue optimization, including identifying appropriate ECC solution, ECC ticket design and maintenance, ECC ticket assignment, and ECC training.

    • Work with IT lead for each ECC to optimize the ECC for operations and ensure accurate financial reporting

  • Staff Management Responsibilities

    • Responsible for all hiring and related personnel decisions, managing performance, staff development, and recognition

    • Manage operational functions including human resources, planning, implementation, and outcomes monitoring

    • Perform duties to promote a Best Place to Work culture and positive work environment

  • Leadership Responsibilities

    • Develop and foster positive relationships with physicians and APPs across all UHPS specialties and through frequent communications that include best practice workflows and optimization recommendations.

    • Provide passionate and highly effective leadership to revenue optimization team

    • Analyze key indicator data, benchmarking and related measures and recommend plans of action

    • Provide direction on initiatives related to the four pillars: access, physician recruiting, quality & patient experience and financial performance

    • Regularly interface with Department and Practice leadership, providing input and updates on strategic coding and revenue initiatives

    • Anticipate workflow and revenue optimization challenges and take proactive steps to problem solve and resolve concerns

    • Complete current state operational assessments and identify best practices, standardize processes make recommendations for improvement
    Additional Responsibilities
  • Performs other duties as assigned.
  • Complies with all policies and standards.
  • For specific duties and responsibilities, refer to documentation provided by the department during orientation.
  • Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.


Qualifications:
Education
  • Bachelor's Degree in business administration or health care related field or equivalent years of practical relevant experience. (Required)

Work Experience
  • 10+ years of operations experience, including understanding of revenue cycle in physician practices. Strong PC skills (Windows, Outlook, IDX, Word, Excel) (Required)
  • Experience with multiple EMRs and charge capture solutions, including design and implementation of operational workflow. (Required)
  • Experience and knowledge of Sunrise and Touchworks EMRs and related charge solutions (Preferred)

Knowledge, Skills, & Abilities
  • Extensive health care operations experience, including point of service workflow, clinical operations workflow, data management, continuous quality improvement in multiple physician practice setting, including doctor's office, outpatient hospital, inpatient hospital, and procedural and diagnostic testing. (Required proficiency)
  • Ability to function independently and as a team player in a fast-paced environment. (Required proficiency)
  • Ability to implement and monitor change. (Required proficiency)
  • Skilled in personal computer use with knowledge of Microsoft programs including Microsoft Office (Word, Excel, PowerPoint, and Visio). (Required proficiency)
  • Strong written and verbal communication skills. (Required proficiency)
Created: 2024-09-12
Reference: 240009LH
Country: United States
State: Ohio
City: Cleveland
ZIP: 44135